Looming Large in Obamacare Talks are Anthem and Blue Crosses

02/27/2017

People in the U.S. mostly waited to sign up for Obamacare coverage until they were sick and this is the complain that Anthem Inc. and other U.S. health insurers have been complaining to the White House for more than a year.

By tightening up on the enrolment rules, the Obama administration should stem their losses, they have been pleading. However, UnitedHealth Group Inc, Humana Inc, and Aetna Inc pulled out of most of the government subsidized health insurance market when their pleas went unmet.

But now the industry is getting a new hearing since the new Trump administration and Republican lawmakers control the future of healthcare. And the loudest industry voice in meetings with policymakers who all have pledged to overthrow former President Barack Obama’s signature law is Anthem - the last national insurer playing big in the Obamacare market.

President Donald Trump is set to meet with insurance industry executives and has said Obamacare coverage is too costly for customers and taxpayers.

According to one healthcare industry lobbyist, including House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell, Republicans leading the change effort have been met “24/7’’ by lobbyists for Anthem and affiliated Blue Cross insurers since the election. The lobbyist reportedly said that they are there “every time Senators and staffers are on the Hill.”

Lawmakers and aides were keen on hearing what the insurers needed to stay in the market, said another industry source who attended some of the meetings.

The optimist statement that policymakers would introduce new enrolment rules limiting when people can opt into coverage, by Anthem Chief Executive Joseph Swedish may be explained by that clout.

"We do have some positive indicators that stabilization could very likely occur,” Swedish said. “I am again hopeful that our recommendations will be looked at very carefully and adopted.”

Proposals of regulations that would force members to pay delinquent premiums if they want to return to the same insurer, establish a new eligibility verification process and shorten the enrolment period were made a day later by the Trump administration as it took its first concrete stab at Obama's Affordable Care Act.

After Anthem said it was considering whether it would remain in 2018, many of the industry’s top demands for shoring up the individual market were addressed by the so-called stabilization proposal.

The Blues is a collection of companies that share a governing board, a brand and networks and Anthem is the largest insurer among it. The vast majority of people covered by Obamacare is covered by them as a group.

And according to people close to the negotiations, the future of an insurance market that covers more than 10 million people is being shaped by the proposals which wield a lot of influence.

"Blue Cross Blue Shield does have a larger role in discussing changes," said an aide to a key Republican Senator.

A legislation that would change access to individual insurance and the Medicaid program for the poor would replace the 2010 law that created Obamacare, Trump has said.

Before Obamacare coverage took effect in 2014, Anthem and other Blue Cross plans dominated the individual market. By financing the start up of about two dozen smaller insurance co-ops, Obamacare sought to stimulate competition and remade that market. By forecasting rapid enrolment growth to more than 20 million people, which failed to materialize, the Obama administration also courted big players, such as Aetna and UnitedHealth.